Provider First Line Business Practice Location Address:
530 MACOBY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PENNSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18073-1112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-679-8076
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/31/2014